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Individual

STEPHEN C ALTMIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
CORNER OF ROUTE N12 AND N7, FORT DEFIANCE, AZ 86504
(928) 729-8000
Mailing address
PO BOX 649, FORT DEFIANCE, AZ 86504-0649
(928) 729-8000

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
39829
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
122680100
WY
05
128190
AZ
05
200389960A
KS
01
20326023101
PACIFICARE SECURE HORIZONS
05
76275329
CO
01
P00334740
RR MEDICARE
CO
05
PENDING
NE
05
Z3293
UT
Enumeration date
02/08/2006
Last updated
01/13/2026
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